Patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) receiving Imbruvica (ibrutinib) as fist-line treatment had higher refill adherence, which was linked with lower all-cause health care resource utilization and total medical costs. These findings were presented during AMCP Nexus 2021.

“Refill adherence to oral hematological therapies such as ibrutinib is essential to maximize therapy benefit and alleviate health care system burden,” the study authors explained.

In order to better understand how refill adherence impacts health care resource utilization and cost outcomes among Medicare Fee-for-Service patients diagnosed with CLL/SLL and treated with single-agent ibrutinib as first-line treatment, a retrospective cohort study was conducted.

For the study, the authors identified Medicare beneficiaries with CLL/SLL treated with ibrutinib between February 12, 2014 through December 31, 2017.

“Proportion of days covered (PDC) was used to calculate refill adherence (non-refill may be due to clinical and non-clinical reasons) during follow-up (fixed 12-month post-index),” they explained. “Patients were deemed adherent if PDC≥0.80.”

Additionally, propensity score matching was used to control the key baseline cofounders between the adherent and non-adherent groups, and the adjusted cost differences between both groups were reported as mean-monthly-cost-difference.

“There were considerable differences in age, gender, and baseline comorbidities between cohorts pre-PSM,” explained the authors. “A total of 929 adherent and 929 non-adherent patients were included post-PSM; baseline demographic, clinical, HRU, and cost variables were well-balanced.”

According to the findings, at 12-month follow-up, adherent patients had fewer all-cause hospitalizations (adherent PPPM=0.03, non-adherent PPPM=0.08, P<0.001), emergency room visits (adherent PPPM=0.05, non-adherent PPPM=0.08, P<0.001), and physician office visits (adherent PPPM=2.71, non-adherent PPPM=3.08, P<0.001). Further, it was reported that all-cause total medical costs were significantly lower in the adherent cohort compared to the non-adherent cohort (MMCD=-$1,747.77, P<0.001).

“Higher refill adherence to [first-line] ibrutinib was associated with significantly lower all-cause [health care resource utilization] and total medical costs among Medicare beneficiaries with CLL/SLL,” the research team concluded.

“These findings demonstrate the value of adherence to [first-line] ibrutinib for reducing health care system burden and avoidable medical costs.”

Reference:

Iyengar R, Murunga A, Volodarsky R, et al. Value of refill adherence to first-line Ibrutinib for treatment of chronic lymphocytic leukemia/small lymphocytic lymphoma: a retrospective claims analysis. Poster presented at: AMCP Nexus 2021; October 18-21, 2021; Denver, CO.